Introduction: Hepatocellular carcinoma (HCC) is the most common primary liver tumor and a leading cause of cancer-related deaths worldwide. Surgical resection is the cornerstone of a broad range of multimodal treatment concepts in HCC. However, high tumor recurrence and low survival rates after surgical resection still constitute a major problem after curative intent resection. Our primary goal was to assess clinico-pathological factors associated with disease-free (DFS) and overall survival (OS) in patients with HCC undergoing hepatic resection.
Material and Methods: Between August 2004 and October 2021, 196 patients underwent elective hepatic resection for hepatocellular carcinoma at our institution. Patient data were collected from a prospectively maintained database. DFS and OS rates in relation to clinical and pathological characteristics and variables were calculated using log rank and multivariate cox regression analyses.
Results: The postoperative 1-, 3- and 5- year overall DFS and OS rates were 77.9%, 49.7%, and 41% respectively 73.9%, 54.7%, and 38.8%. BMI ? 26.12 (p= 0.040), diabetes mellitus type 2 (p= 0.015), N-Stage (p= 0.022), tumor grading (p= 0.020), and postoperative liver failure ISGLS grade B/C (p>0.0001) were significantly associated with OS while chronic alcohol abuse (p= 0.20), tumor diameter? 4.5 cm (p= 0.020), and postoperative intra-abdominal abscess formation (p> 0.0001) were significant determinants of DFS.
Summary: Advanced tumor stage with higher tumor grading and nodal metastasis, BMI and diabetes mellitus as well as postoperative liver failure ISGLS grade B/C significantly predict OS after curative resection in HCC. Concomitantly, tumor recurrence is influenced by chronic preoperative alcohol abuse, tumor diameter and postoperative abscess formation. Potential therapeutic approaches focusing on these variables may help to achieve higher OS and DFS rates.
